Gross Positioning Device and Related Systems and Methods

ABSTRACT

Disclosed herein are gross positioning systems for use with robotic surgical devices to provide gross positioning of the robotic surgical devices. The gross positioning systems have a base, a first arm link operably coupled to the base, a second arm link operably coupled to the first arm link, a third arm link operably coupled to the second arm link, and a slidable coupling component slidably coupled to the third arm link.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application claims priority as a continuation application to U.S.application Ser. No. 17/838,883, filed Jun. 13, 2022 and entitled “GrossPositioning Device and Related Systems and Methods,” which claimspriority as a continuation application to U.S. application Ser. No.15/821,169, filed on Nov. 22, 2017 and entitled “Gross PositioningDevice And Related Systems And Methods,” which issued as U.S. Pat. No.11,357,595 on Jun. 14, 2022, which claims the benefit under 35 U.S.C. §119(e) to U.S. Provisional Application 62/425,149, filed Nov. 22, 2016and entitled “Gross Positioning Device and Related Systems and Methods,”which is hereby incorporated herein by reference in its entirety.

GOVERNMENT SUPPORT

This invention was made with government support under Grant No.W81XWH-14-1-0058, awarded by the U.S. Department of Defense. Thegovernment has certain rights in the invention.

FIELD OF THE INVENTION

The various embodiments herein relate to robotic surgical devices, andmore specifically to gross positioning systems and devices that aid inthe gross repositioning of surgical devices during surgical procedures.The combination of a gross positioning system with an in vivo surgicaldevice results in an increase in the degrees of freedom of the in vivodevice without increasing the size of the device.

BACKGROUND OF THE INVENTION

The known positioning systems currently used for robotic surgery arelarge and cumbersome. For example, the Da Vinci SP Surgical System™takes up a significant portion of the operating room and creates acrowded space over the surgical site, and the system created by WasedaUniversity has bulky motor housings that create a larger than necessaryprofile. In a further example, the Raven™ mimics current laparoscopictechniques by inserting a single tool (in contrast to the in vivo robotsystems used in the other two systems discussed above).

FIGS. 1A and 1B depict a known, generic spherical mechanism 10 and thenecessary workspace 16 of the mechanism to reach the extents of theabdominal cavity of a patient. A “spherical mechanism” is a physicalmechanism or software application that can cause all end effectormotions to pass through a single point, thereby allowing a surgicalsystem to use long rigid tools that perform procedures through incisionsthat serve as single pivot points. As an example, both COBRASurge andthe Raven have mechanical spherical mechanisms, while Da Vinci has asoftware-based spherical mechanism.

This known mechanism as shown in FIGS. 1A and 1B has a cable-driven toolcoupled to it. The link angles 12, 14 in the device 10 have beenoptimized at the University of Washington's BioRobotics lab to createthe workspace 16 depicted in FIG. 1B. The workspace 16 is an ellipticalcone 90° in the lateral directions and 60° in the cranial/caudaldirection with a remote center 18 that is disposed at the bottom of thecone 16. The link angles 12, 14 can be changed for different workspaces.There is a need in the art for an improved gross positioning system.

BRIEF SUMMARY OF THE INVENTION

Discussed herein are various gross positioning systems for use with invivo robotic surgical devices.

In Example 1, a gross positioning system for use with a robotic surgicaldevice comprises a base, a first arm link operably coupled to the baseat a first rotational joint, a second arm link operably coupled to thefirst arm link at a second rotational joint, a third arm link operablycoupled to the second arm link, and a slidable coupling componentslidably coupled to the third arm link such that the slidable couplingcomponent can move along a length of the third arm link between anextended position and a retracted position. The third arm link isrotatable about a third rotational joint and is configured to bepositionable through an incision in a patient. The slidable couplingcomponent is configured to be coupleable to the robotic surgical device.

Example 2 relates to the gross positioning system according to Example1, wherein an axis of rotation of the first rotational joint, an axis ofrotation of the second rotational joint, and an axis of rotation of thethird rotational joint intersect at a single point of intersection.

Example 3 relates to the gross positioning system according to Example2, wherein wherein the single point of intersection is a sphericaljoint.

Example 4 relates to the gross positioning system according to Example2, wherein the single point of intersection is disposed at some pointalong a portion of the robotic surgical device.

Example 5 relates to the gross positioning system according to Example2, wherein the gross positioning system is positioned such that thesingle point of intersection is disposed at an incision in a patient.

Example 6 relates to the gross positioning system according to Example5, wherein the third arm link is disposed through the single point ofinsertion.

Example 7 relates to the gross positioning system according to Example2, wherein the single point of intersection is disposed at an insertionpoint of a patient.

Example 8 relates to the gross positioning system according to Example7, wherein the insertion point comprises an incision or a naturalorifice.

Example 9 relates to the gross positioning system according to Example7, wherein the third arm link is disposed through the single point ofintersection.

Example 10 relates to the gross positioning system according to Example1, wherein the robotic surgical device comprises at least one arm,wherein the gross positioning system and robotic surgical device areconfigured to operate together to position the robotic surgical devicewithin a body cavity of a patient.

Example 11 relates to the gross positioning system according to Example10, further comprising a controller operably coupled to the grosspositioning system and the robotic surgical device.

In Example 12, a gross positioning system for use with a roboticsurgical device comprises a base, a first arm link operably coupled tothe base at a first rotational joint, a second arm link operably coupledto the first arm link at a second rotational joint, a third arm linkoperably coupled to the second arm link at a third rotational joint, aslidable coupling component slidably coupled to the third arm link suchthat the slidable coupling component can move along a length of thethird arm link between an extended position and a retracted position,and the robotic surgical device operably coupled to the slidablecoupling component. The robotic surgical device comprises a device body,a first arm operably coupled to the device body, and a second armoperably coupled to the device body. The first arm comprises at leastone first actuator and the second arm comprises at least one secondactuator.

Example 13 relates to the gross positioning system according to Example12, wherein an axis of rotation of the first rotational joint, an axisof rotation of the second rotational joint, and an axis of rotation ofthe third rotational joint intersect at a single point of intersection.

Example 14 relates to the gross positioning system according to Example12, wherein the third arm link is disposed through the single point ofintersection and further is configured to be positionable through aninsertion point in a patient.

In Example 15, a external gross positioning system for use with aninternal robotic surgical device comprises a base, a first arm linkoperably coupled to the base at a first rotational joint, a second armlink operably coupled to the first arm link at a second rotationaljoint, a third arm link operably coupled to the second arm link at athird rotational joint, a slidable coupling component slidably coupledto the third arm link such that the slidable coupling component ismoveable along a length of the third arm link between an extendedposition and a retracted position, and a single point of intersection atan intersection of an axis of rotation of the first rotational joint, anaxis of rotation of the second rotational joint, and an axis of rotationof the third rotational joint. The slidable coupling component isconfigured to be coupleable to the robotic surgical device. The singlepoint of intersection is disposed at an insertion point of a patient.

Example 16 relates to the gross positioning system according to Example15, wherein a portion of the third arm link is disposed through thesingle point of intersection.

Example 17 relates to the gross positioning system according to Example15, wherein a portion of the robotic surgical device is disposed throughthe single point of intersection.

Example 18 relates to the gross positioning system according to Example15, wherein the insertion point is an incision.

Example 19 relates to the gross positioning system according to Example15, wherein the robotic surgical device comprises at least one arm,wherein the gross positioning system and robotic surgical device areconfigured to operate together to position the robotic surgical devicewithin a body cavity of the patient.

Example 20 relates to the gross positioning system according to Example19, further comprising a central processing unit operably coupled to thegross positioning system and the robotic surgical device and acontroller operably coupled to the central processing unit. The centralprocessing unit comprises software configured to transmit controlinstructions to the gross positioning system and the robotic surgicaldevice.

In Example 21, a gross positioning system for use with a roboticsurgical device comprises a base, a first arm link operably coupled tothe base at a first rotational joint, a second arm link operably coupledto the first arm link at a second rotational joint, a third arm linkoperably coupled to the second arm link at a third rotational joint, aslidable coupling component slidably coupled to the third arm link, andthe robotic surgical device operably coupled to the slidable couplingcomponent. Further, the robotic surgical device comprises a device body,a first arm operably coupled to the device body, the first armcomprising at least one first actuator, and a second arm operablycoupled to the device body, the second arm comprising at least onesecond actuator. In addition, the third arm link is positionable throughan insertion point in a patient such that the robotic surgical device ispositionable within a body cavity of the patient.

Example 22 relates to the gross positioning system according to Example21, wherein the slidable coupling component is slidable along a lengthof the third arm link between an extended position and a retractedposition.

Example 23 relates to the gross positioning system according to Example21, wherein an axis of rotation of the first rotational joint, an axisof rotation of the second rotational joint, and an axis of rotation ofthe third rotational joint intersect at a single point of intersectionand the third arm link is disposed through the single point ofintersection.

While multiple embodiments are disclosed, still other embodiments of thepresent invention will become apparent to those skilled in the art fromthe following detailed description, which shows and describesillustrative embodiments of the invention. As will be realized, theinvention is capable of modifications in various obvious aspects, allwithout departing from the spirit and scope of the present invention.Accordingly, the drawings and detailed description are to be regarded asillustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a perspective view of a known spherical mechanism.

FIG. 1B is a perspective view of the workspace of the known sphericalmechanism of FIG. 1A.

FIG. 2A is a perspective view of a gross positioning device coupled toan in vivo robotic device that is disposed within a cavity of a patient,according to one embodiment.

FIG. 2B is another perspective view of the gross positioning device andin vivo robotic device of FIG. 2A disposed within the cavity of thepatient.

FIG. 2C is another perspective view of the gross positioning device andin vivo robotic device of FIG. 2A disposed within the cavity of thepatient.

FIG. 3 is an exploded perspective view of a gross positioning device,according to one embodiment.

FIG. 4 is an expanded, exploded perspective view of the first joint ofthe device of FIG. 3 .

FIG. 5 is an expanded, exploded perspective view of the second joint ofthe device of FIG. 3 .

FIG. 6 is an expanded, exploded perspective view of the third joint ofthe device of FIG. 3 .

FIG. 7 is an expanded, exploded perspective view of the couplingcomponent of the device of FIG. 3 coupled to a robotic device.

FIG. 8 is a side view of a gross positioning device and the actual axesof rotation resulting at each joint, according to one embodiment.

FIG. 9 is a perspective view of the gross positioning device and theglobal axes of rotation created by the actual axes of rotation of FIG. 8.

FIG. 10 is a schematic depiction of a control process for controlling agross positioning device, according to one embodiment.

FIG. 11 is a perspective view of a controller, according to oneembodiment.

FIG. 12 is a perspective view of another controller, according to afurther embodiment.

FIG. 13A depicts a perspective view of the arms of robotic device,according to one embodiment.

FIG. 13B depicts a perspective view of the arms of the robotic device ofFIG. 13A.

FIG. 14A is a side view of a gross positioning device coupled to an invivo robotic device that is disposed within a cavity of a patient,according to one embodiment.

FIG. 14B is another side view of the gross positioning device and invivo robotic device of FIG. 14A disposed within the cavity of thepatient.

DETAILED DESCRIPTION

The various embodiments disclosed or contemplated herein relate to animproved gross positioning device that is coupled to a dexterous in vivorobotic device such that the gross positioning device can be used forglobal orientation of the robotic device within the cavity of a patientas described in further detail herein.

The various gross positioning device implementations disclosed orcontemplated herein can be used to automatically grossly position asurgical device inside a cavity of a patient. “Gross positioning,” asused herein, is intended to mean general positioning of an entiremoveable surgical device (in contrast to precise movement and placementof the specific components of such a device, such as an arm or endeffector). In known robotic surgical systems, the gross positioning ofthose devices during a surgical procedure can be a challenging task.Further, minimally invasive surgical procedures (using either robotic ornon-robotic systems) frequently require a surgical technician toreposition the surgical equipment, such as a laparoscope. Such grossrepositioning takes time and additional effort. In addition, in somecases, the surgical technician is a junior medical student who is notfully trained in laparoscopy. As a result, the repositioninginstructions from the surgeon often result in an obstructed and/orfogged view of the surgical site, requiring additional cognitiveresources from the surgeon. Hence, the Da Vinci® system as well as knownsingle incision surgical devices often require timely manualrepositioning of the patient, the robotic system, or both whileperforming complicated procedures.

The various gross positioning devices contemplated herein aid in thegross repositioning of surgical devices (including, for example, anysurgical devices that have a device body or rod configured to bepositioned through an incision and at least one robotic arm coupled tothe device body that is positioned entirely within the cavity of thepatient) throughout the procedure without additional intervention ormanual repositioning from the surgical staff. The gross positioningsystem embodiments are capable of controlling the degrees of freedom,azimuth and elevation angle, and roll and translation about the axis ofinsertion of laparoscopic surgical tools, including robotic laparoscopicsurgical tools. As a result, the gross positioning device embodimentsdisclosed and contemplated herein can grossly position a surgical devicethrough an incision into a patient cavity, such as the abdominal cavity,with high manipulability, reducing the operative time and stress inducedupon the surgical staff. The combination of the external grosspositioning system with the internal surgical device system will allowthe degrees of freedom of the internal system to effectively increasewithout increasing the size of the surgical robot/device.

In one implementation, the various devices described and contemplatedherein can be used with any single site surgical device with anavailable external positioning fixture, such as a protruding body, rod,or magnetic handle.

FIGS. 2A-2C depict a gross positioning device 20 with an in vivo roboticdevice 22 coupled thereto. The three figures depict the device 20orienting the robotic device 22 in three different positions within thecavity 24 of the patient through an incision 26. The device 20 has abase (also referred to as a “body”) 28, a first arm link (or “upperarm”) 30, a second arm link (or “forearm”) 32, and a third link (or“extender”) 34. The robotic device 22 has a body 38 with two arms 40,with each arm 40 having an actuator 46 and an end effector 42. Theextender 34 has a coupling component 36 that couples directly to thebody 38 of the robotic device 22 such that the body 38 is disposedthrough the incision 26 that provides access to the cavity 24 (or, moretypically, through a port (not shown) disposed in the incision 26 thatprovides access to the cavity 24).

As shown, the links 30, 32, 34 of the positioning device 20 (and anyother positioning device embodiment disclosed or contemplated herein)allow the robotic device 22 to access the full extent of the workspacewithin the cavity 24. That is, the positioning device 20 makes itpossible to position the robotic device 22 within the patient's cavity24 with the body 38 of the device 22 positioned through the incision 26(or port disposed in the incision 26) such that the end effectors 42attached to the arms 40 of the robotic device 22 can reach any desiredlocation in the workspace in the cavity 24 while the links 30, 32, 34 ofthe positioning device 20 function to create a “spherical joint” 44where the device body 38 passes through the incision 26 such that allmovements of the robotic device 22 pass through a single point. In otherwords, regardless of the positioning of the three links 30, 32, 34 andthe resulting positioning of the robotic device 22 within the patient'scavity 24, the portion of the device body 38 at the incision 26 (thespherical joint 44) remains in the same position (through the incision26) as a result of the positioning device 20. This allows operation of arobotic device (such as robotic device 22) within a cavity (such ascavity 24) such that the end effectors (such as end effectors 42) canreach any desired location within the cavity while the entire device 22is connected to the positioning device 20 via a device body 38 thatpasses through and never moves from a single point (the spherical joint44) at the incision 26, thereby making it possible to operate andposition the device 22 through that single incision (such as incision26). The creation of the spherical joint 44 by the positioning device 20will be described in further detail below. Another advantage is that thepositioning device 20 makes it possible to use the single in vivorobotic device within the patient's cavity instead of the multiple armsof the known Da Vinci™ system extending from the patient's cavity andthereby taking up a great deal of workspace outside the body of thepatient.

FIG. 3 depicts an exploded view of the components of the grosspositioning device 20. As will be described in further detail below, thedevice 20 has three degrees of freedom (“DOF”) and can utilize thoseDOFs to provide global orientation for the robotic device 22 (as bestshown in FIGS. 2A-2C) coupled to positioning device 20. As discussedabove, the device 20 has the base 28, the first arm link 30, the secondarm link 32, the third link 34, and the coupling component 36. In thisimplementation, the first arm link 30 has a cover 30A and the second armlink 32 has a cover 32A. Alternatively, each of the links 30, 32 is asingle, unitary component without a cover.

As best shown in FIGS. 3 and 4 , the first arm link 30 is rotatablycoupled to the base 28 at a first joint 50. More specifically, the base28 is made up of a bracket 52 that is configured to receive a firstmotor 54 that is rotatably coupled to the bracket 52 and a bearing 56,thereby creating the first joint 50. That is, the motor 54 is positionedin the openings 58A, 58B such that the motor 54 rotates within thoseopenings 58A, 58B. The first link 30 is fixedly coupled to the firstmotor 54 such that actuation of the first motor 54 causes rotation ofthe motor 54 in relation to the bracket 52, thereby causing rotation ofthe first link 30 around the first joint 50.

In one implementation, the base 28 is configured to keep the entiredevice 20 stable and secure during use. As shown, the base 28 is abracket 52 as discussed above. In alternative embodiments, the base 28can be any structure that provides such stability, including, forexample, a very heavy or weighted structure that uses the weight toenhance stability. In certain implementations, the base 28 can be stablycoupled to a surgical table on which the patient is placed. For example,the base 28 can be coupled to a rail (not shown) on the table (notshown). In a further alternative, the base 28 can be coupled to anyfixed object in the operating room. Alternatively, the base 28 can becoupled to or be an integral part of a cart or other mobile standaloneunit.

As best shown in FIGS. 3 and 5 , the first arm link 30 and the secondarm link 32 are rotatably coupled to each other at a second joint 60.More specifically, the joint 60 is made up of a bracket 62 that isconfigured to receive a second motor 64 that is rotatably coupled to thebracket 62 and a bearing 66, thereby creating the second joint 60. Thatis, the motor 64 is positioned in the openings 68A, 68B such that themotor 64 rotates within those openings 68A, 68B. The first link 30 isfixedly coupled to the second motor 64 and the second link 32 is fixedcoupled to the bracket 62 such that actuation of the second motor 64causes rotation of the motor 64 in relation to the bracket 62, therebycausing rotation of the second link 32 in relation to the first link 30around the joint 60.

As best shown in FIGS. 3 and 6 , the third link 34 is rotatably coupledto the second arm link 32 at a third joint 70. More specifically, thejoint 70 is made up of a third motor 72 that is fixedly coupled to thesecond arm link 32 and rotatably coupled to the third link 34 such thatactuation of the motor 72 causes rotation of the third link 34, therebycreating the third joint 70. As best shown in FIGS. 3 and 7 , the thirdlink 34 has the coupling component 36 at the distal end of the link 34such that a robotic device 74 can be coupled thereto. It is understoodthat the object 74 depicted in FIGS. 3 and 7 is intended to represent anin vivo robotic device 74. In this specific example, only the rod orbody 76 of the device 74 is shown, but not the robotic arms or othercomponents. It is understood that this particular body component 76 asshown is merely intended as a schematic depiction of the device 74, andnot a fully depiction of an actual robotic device having robotic arms(such as the device 22 discussed and depicted above). Thus, actuation ofthe third motor 72 causes rotation of the robotic device via therotation of the third link 34.

Alternatively, any joint configurations can be used in the various grosspositioning device implementations, so long as the links 30, 32, 34 canmove in relation to each other as described herein.

According to one implementation, the coupling component 36 is slidablycoupled to the third link 34 such that the coupling component 36 (andthus the robotic device 74) can be positioned anywhere along thelongitudinal length of the third link 34. As such, the robotic device 74can be moved toward and away from the third joint 70 as desired toposition the device 74 along the longitudinal axis of the third link 34.In accordance with certain embodiments, the coupling component 36 has aquick-release handle 78 that can be actuated to fix or unfix theposition of the coupling component 36 along the length of the third link34. That is, the handle 78 can be actuated to move the couplingcomponent 36 into the unfixed configuration such that the component 36can slide along the length of the link 34. Once the coupling component36 (and thus the robotic device 74) is positioned at the desired pointalong the length of the link 34, the handle 78 can be moved into thefixed position, thereby fixing the coupling component 36 at that pointsuch that the component 36 is not slidable. Thus, the coupling component36 can move along the length of the third link 34 between an extendedposition and a retracted position and any position therebetween.Alternatively, the third link 34 can have any known component or devicethat provides for movement between an extended and retracted position.

FIG. 8 depicts the axes of rotation 90, 92, 94 created by the joints 50,60, 70 and further depict the linear stage D created by the couplingcomponent 36 and third link 34. That is, rotation around axis 90 asshown at arrow A is caused by rotation of the first joint 50. Further,rotation around axis 92 as shown at arrow B is caused by rotation of thesecond joint 60. Finally, rotation around axis 94 as shown at arrow C iscaused by rotation of the third joint 70. In addition, the linearmovement represented by the arrow D results from the movement of thecoupling component 36 along the third link 34. In one embodiment, thelinear movement of the coupling component 36 is utilized at thesurgeon's discretion to position the robotic device 74 further into thecavity of the patient (not shown) or to move the robotic device closerto the joint 70. In one implementation, the movement of the couplingcomponent 36 in relation to the third link 34 is manual (and requiresactuation of the quick-release lever 78 discussed above). Alternatively,the movement of the coupling component 36 can be motorized.

In one embodiment, the rotational axis 90 at rotational joint 50 isperpendicular to both the rotational axis 92 at rotational joint 60 andthe rotational axis 94 at joint 70. In other words, each axis 90, 92, 94can be perpendicular in relation to the other two. The three axes 90,92, 94 being perpendicular can, in some implementations, simplify thecontrol of the system 20 by causing each axis 90, 92, 94 to contributesolely to a single degree of freedom. For example, if the third link 34is rotated around axis 94, the tilt of the in vivo robotic device 74does not change when all three axes 90, 92, 94 are perpendicular.Similarly, if the first link 30 is rotated around axis 90, only the tiltof the surgical device 74 from side to side is affected. Alternatively,two of the three axes 90, 92, 94 are perpendicular to each other. In afurther alternative, none of the axes 90, 92, 94 are perpendicular toeach other.

FIG. 9 shows how the three local axes of rotation 90, 92, 94 of FIG. 8result in the global orientation of the in vivo robot 74. That is, FIG.8 depicts the actual axes of rotation 90, 92, 94 relating to each of thejoints 50, 60, 70, respectively. In contrast, FIG. 9 depicts the globalaxes of rotation 100, 102, 104 that are created by the actual axes ofrotation 90, 92, 94. That is, the global axes 100, 102, 104 are the axesused to describe the actual or desired orientation of the robotic device(such as device 74, for example). Thus, the axes 90, 92, 94 createglobal axis 100 such that rotation around axis 100 as shown at arrow Dis the “pitch” rotation of the device 74. Further, the axes 90, 92, 94create global axis 102 such that rotation around axis 102 as shown atarrow E is the “roll” rotation of the device 74. In addition, the axes90, 92, 94 create global axis 104 such that rotation around axis 104 asshown at arrow F is the “yaw” rotation of the device 74. As such,according to certain embodiments, a desired global orientation of thedevice 74 can be controlled by the axes 90, 92, 94. For example, if thepitch of the device 74 is desired to be 90 degrees, then the local axes90, 92, 94 can be rotated as necessary to some solved value such thatthe robotic device 74 has a pitch of 90 degrees.

In one embodiment, as best shown in FIG. 8 , the three axes 90, 92, 94intersect at the intersection 100, also known as the “spherical joint”100 as described above. The intersection 100 remains fixed at the samelocation, regardless of the positioning of the arm links 30, 32, 34, andcan be used as the insertion point during surgeries. That is, the grosspositioning system 20 can be positioned such that the intersection 100is positioned at the incision in the patient through which the roboticdevice 74 is positioned.

In one implementation, the intersection 100 causes the system 20 to actsimilarly to a spherical mechanism, as described above. In the device 20as shown in FIG. 8 , the configuration of the device 20 creates thespherical joint 100 such that the extender 34 must pass through thesingle point of the spherical joint 100, which is typically positionedat the incision in the patient. The spherical joint 100 created by thedevice 20 increases the size of the effective workspace for the surgicaldevice 74 within the cavity of the patient while maintaining thespherical joint 100 at the incision.

Alternatively, the gross positioning device 20 can have a fourth link, afifth link, or any number of additional links, and a related additionalnumber of rotational joints. Further, the device 20 can also have fewerthan three links, and a related number of rotational joints. In sum, thegross positioning device 20 can have a single rotational joint, tworotational joints, or any number of rotational joints.

According to one embodiment, the gross positioning device 20 can becontrolled using the following control process 120 as shown in FIG. 10 ,according to one embodiment. A controller 122 is provided that is usedas an input to communicate with the software architecture 124(informally called the “RobotApp” in this exemplary embodiment). Inaccordance with one implementation, the software 124 is custom software124 that allows for the integration of the different hardware anddevelopment of “plugins,” thereby resulting in a modular platform onwhich it is easy to build additional features. Alternatively, thesoftware architecture 124 limits the use of hardware to a limited set ofhardware and has no modularity. In a further alternative, the softwarearchitecture 124 can be any known type of architecture.

The communication from the controller 122 is interpreted (or“conditioned) by the software 124 (block 126) and used to calculate thekinematics (block 128). These kinematic calculations are thencommunicated to the gross positioning device 20 via a connection 130such that the device 20 is actuated to move as communicated from thecontroller 122. In this specific embodiment, the connection is a USBport 130 in the hardware (not shown) that contains the software 124. Theport 130 allows for connection of the gross positioning device 20 to thesoftware 124 and thus to the controller 122. In one implementation, thecontroller 122 is the hardware that contains the software 124.Alternatively, the hardware can be any processing unit, such as acomputer.

According to certain embodiments, a hand controller is used to controlthe gross positioning device and/or the robotic device. In oneimplementation, the hand controller 150 is a joystick controller 150 asdepicted in FIG. 11 . The joystick controller 150 controls theorientation of the gross positioning device (such as device 20) Afurther controller embodiment 152 is depicted in FIG. 12 , in which thecontroller 152 is the commercially available GeoMagic Touch™ controller152. In this implementation, the controller 152 can be used to controlthe gross positioning device (such as device 20). In a furtherembodiment, the controller 152 can be used to control both the grosspositioning device (such as device 20) and the robotic device (such asdevice 22), but the control scheme must be changed each time the userwants to switch from controlling one of the devices to the other.

In another embodiment, two GeoMagic Touch™ controllers 152 are used incombination with a control process or application that allows forcontrol of both the gross positioning device (such as device 20) and therobotic device (such as device 22) without having to change controlschemes during a procedure. Instead, as best shown in FIGS. 13A and 13B,for purposes of the control process, the midpoint 160 between the twoendpoints (end effectors) 162 of the in vivo robot 166 was identified.Using polar coordinates (θ, Φ), a midpoint envelope 164 was developedsuch that if the midpoint 160 leaves the area of the envelope 164, thenthe orientation of the in vivo robotic device 166 will be movedaccordingly via the gross positioning device (such as device 20). Morespecifically, if the midpoint 160 of the end effectors 162 reaches theextent of the envelope 164, then the gross positioning device (such asdevice 20) will begin moving to adjust the view of the camera lens 168on the device 166. As such, the robotic device 166 can control the viewof the camera lens 168 by reaching or “gesturing” up, down, left, orright to move the camera lens 168 to the desired view. In order to stopthe movement of the gross positioning device, the end effectors 162 mustbe returned to the midpoint profile (that is, they must be moved suchthat the midpoint 160 is within the envelope 164. In this way, the grosspositioning device (such as device 20) and the robotic device (such asdevice 22) can both be operated such that the robotic device can reachthe extent of the patient's cavity without changing control schemes.

In one embodiment, the midpoint envelope 164 corresponds to the extentof the camera lens 168. Alternatively, other approaches could be usedfor different cameras or if the robotic device has an optimal workspacewithin which it must stay.

Alternatively, the control process can operate in a different fashion,as best shown in FIGS. 14A and 14B. In this particular embodiment, ifthe midpoint 160 exits the envelope 164, both the gross positioningdevice (such as device 20) and the in vivo robotic device 166 could movetogether to keep the end effectors 162 fixed in space but return theminside the midpoint envelope 164 as shown. More specifically, the endeffectors 162 are first offset to the right of the robotic device 166,but by repositioning the gross positioning device (such as device 20)and in vivo robot 166 together, the endpoints 162 remain fixed in space,but are returned inside the midpoint envelope 164.

In use, the gross positioning device 20 and other embodiments disclosedor contemplated herein can operate in the following fashion to positionthe surgical device (such as device 22, device 74, or device 166) withinthe surgical space in the cavity of the patient through the incision.The three links 30, 32, 34 rotate about the respective axes 90, 92, 94to position the device 22, 74, 166 as desired. More specifically, thethird link 34 can be rotated around axis 94 to rotate the surgicaldevice 22, 74, 166 about the axis 94. Further, the arm links 30, 32 incombination with the extender 34 can be used to articulate the device 20through two separate angular planes. That is, the two axes 90, 92 canaffect the angular position of the extender 34. In addition, thecoupling component 36 can be extended or retracted to allow for thesurgical device 22, 74, 166 to be advanced into and out of the cavity ofthe patient.

In one implementation, the positioning system 20 and the surgical device22, 74, 166 can be used in combination, such that the surgical device22, 74, 166 is treated as an extension of the positioning system 20wherein both are used together to move and operate the surgical device22, 74, 166. For example, the surgeon may want to move the surgicaldevice 22, 74, 166 a total of one inch to the right and thus actuates anexternal controller to cause this move. The controller (such as anycontroller embodiment discussed above) transmits the appropriate signalsto the positioning system 20 and the surgical device 22, 74, 166 suchthat the system 20 and device 22, 74, 166 work in combination to movethe surgical device 22, 74, 166 one inch to the right. In one example,the system 20 could move 0.5 inches and the device 22, 74, 166 couldmove 0.5 inches, thereby resulting in the device 22, 74, 166 moving thefull one inch as desired. According to one embodiment, the positioningsystem 20 can thus be used to maximize the strength, workspace, andmaneuverability of the combination of the system 20 and the device 22,74, 166 by determining the optimal contribution of each component duringuse.

Alternatively, the positioning system 20 and the device 22, 74, 166operate separately. That is, the system 20 is not operable or does notoperate while the device 22, 74, 166 is being used, and the device 22,74, 166 is not operable or does not operate while the system 20 is beingused. For example, if the device 22, 74, 166 is being used and it isdetermined that a target object in the surgical space is outside thereach of the device 22, 74, 166, the device 22, 74, 166 is “shut down,”otherwise rendered inoperable, or simply placed in a “pause mode,” andthe system 20 is used to reposition the device 22, 74, 166 accordingly.

It is understood that the device 20 can be operably coupled to aprocessor or computer (not shown) such that the processor can be used tocontrol the positioning system 20, including movement of the arm links30, 32, 34 to grossly position the surgical device 22, 74, 166.

In a further alternative implementation, the positioning system 20 canalso be configured to incorporate or integrate equipment or devices thatcouple to the surgical device 22, 74, 166 to provide variousfunctionalities to the device 22, 74, 166. For example, in oneembodiment, the system 20 can contain suction and irrigation equipmentthat couples to corresponding equipment in the surgical device 22, 74,166 such that the surgical device 22, 74, 166 includes suction andirrigation components. In another example according to a furtherimplementation, the positioning device 20 can contain any knownequipment that is configured to couple to corresponding equipment in thesurgical device 22, 74, 166.

Alternative embodiments contemplated herein also include systems thatcan be used with surgical devices that are magnetically controlled (incontrast to the surgical devices described above, which are controlledvia a body or positioning rod inserted through the surgical incision).In those implementations, the positioning system positions the surgicaldevice anywhere along an internal surface inside the patient's cavity bypositioning an external magnetic component (such as a magnetic handle orother type of external magnetic component) along the outer skin of thepatient. This positioning of the device can include any combination ofmovement in two dimensions along the surface of the patient's skin aswell as rotation of the external magnetic component about an axisperpendicular to the surface of the skin. Of course, it is understoodthat while the movement of the magnetic component along the skin of thepatient is considered to be two dimensional, the patient's skin iscurved such that movement of the external component along the skindemonstrates absolute manipulation in all six degrees of freedom.

Although the present invention has been described with reference topreferred embodiments, persons skilled in the art will recognize thatchanges may be made in form and detail without departing from the spiritand scope of the invention.

1. A robotic surgical system for performing surgery on a patient, thesystem comprising: (a) a gross positioning device comprising: (i) abase; (ii) a first arm link operably coupled to the base at a firstrotational joint; (iii) a second arm link operably coupled to the firstarm link at a second rotational joint; (iv) a third arm link operablycoupled to the second arm link, wherein the third arm link is rotatableabout a third rotational joint; and (v) a coupling mechanism coupled tothe third arm link such that the coupling mechanism is moveable along alength of the third arm link between an extended position and aretracted position; (b) a robotic surgical device removably coupled tothe coupling mechanism, the robotic surgical device comprising: (i) adevice body; (ii) a first arm operably coupled to the device body; and(iii) a second arm operably coupled to the device body; (c) a controlleroperably coupled to the gross positioning device and the roboticsurgical device, the controller comprising at least one hand controller;and (d) a processor operably coupled to the controller, the processor isconfigured to generate control instructions for the gross positioningdevice and the robotic surgical device such that the gross positioningdevice and the robotic surgical device operate together to position therobotic surgical device and the first and second arms within a bodycavity of the patient.
 2. The robotic surgical system of claim 1,wherein at least two of an axis of rotation of the first rotationaljoint, an axis of rotation of the second rotational joint, and an axisof rotation of the third rotational joint substantially intersect at asingle point of intersection.
 3. The robotic surgical system of claim 2,wherein the single point of intersection is disposed at an insertionpoint of the patient.
 4. The robotic surgical system of claim 2, whereinthe third arm link or the device body is disposed through the singlepoint of intersection.
 5. The robotic surgical system of claim 1,wherein the processor is configured to generate the control instructionsfor the gross positioning device and the robotic surgical device suchthat the gross positioning device and the robotic surgical deviceoperate together simultaneously to position the robotic surgical deviceand the first and second arms within the body cavity of the patient. 6.The robotic surgical system of claim 1, wherein the processor isconfigured to generate the control instructions for the grosspositioning device and the robotic surgical device such that a first ofthe gross positioning device and the robotic surgical device operates toposition the robotic surgical device and the first and second armswithin the body cavity of the patient while a second of the grosspositioning device and the robotic surgical device is inoperable.
 7. Therobotic surgical system of claim 1, wherein the at least one handcontroller is operably coupled to the processor such that manipulationof the at least one hand controller causes the processor to generate thecontrol instructions.
 8. The robotic surgical system of claim 1, whereinthe processor is configured to identify a midpoint between endpoints ofthe first and second arms and, when the midpoint is positioned outside apredetermined area, to generate the control instructions such that atleast one of the gross positioning device and the robotic surgicaldevice operates to move the midpoint back within the predetermined area.9. A robotic surgical system for performing surgery on a patient, thesystem comprising: (a) a gross positioning device comprising: (i) abase; (ii) a first arm link operably coupled to the base at a firstrotational joint; (iii) a second arm link operably coupled to the firstarm link at a second rotational joint; (iv) a third arm link operablycoupled to the second arm link, wherein the third arm link is rotatableabout a third rotational joint; and (v) a coupling mechanism coupled tothe third arm link such that the coupling mechanism is moveable along alength of the third arm link between an extended position and aretracted position, wherein at least two of an axis of rotation of thefirst rotational joint, an axis of rotation of the second rotationaljoint, and an axis of rotation of the third rotational jointsubstantially intersect at a single point of intersection; (b) a roboticsurgical device removably coupled to the coupling mechanism, the roboticsurgical device comprising: (i) a device body; (ii) a first arm operablycoupled to the device body, the first arm comprising a first actuator;and (iii) a second arm operably coupled to the device body, the secondarm comprising a second actuator; (c) a controller operably coupled tothe gross positioning device and the robotic surgical device, thecontroller comprising first and second hand controllers; and (d) aprocessor operably coupled to the controller, the processor isconfigured to generate control instructions for the gross positioningdevice and the robotic surgical device such that the gross positioningdevice and the robotic surgical device operate together to position therobotic surgical device and the first and second arms within a bodycavity of the patient.
 10. The robotic surgical system of claim 9,wherein the single point of intersection is disposed at an insertionpoint of the patient.
 11. The robotic surgical system of claim 9,wherein the third arm link or the device body is disposed through thesingle point of intersection.
 12. The robotic surgical system of claim9, wherein the processor is configured to generate the controlinstructions for the gross positioning device and the robotic surgicaldevice such that the gross positioning device and the robotic surgicaldevice operate together simultaneously to position the robotic surgicaldevice and the first and second arms within the body cavity of thepatient.
 13. The robotic surgical system of claim 9, wherein theprocessor is configured to generate the control instructions for thegross positioning device and the robotic surgical device such that afirst of the gross positioning device and the robotic surgical deviceoperates to position the robotic surgical device and the first andsecond arms within the body cavity of the patient while a second of thegross positioning device and the robotic surgical device is inoperable.14. The robotic surgical system of claim 9, wherein the first and secondhand controllers are operably coupled to the processor such thatmanipulation of the first and second hand controllers causes theprocessor to generate the control instructions.
 15. The robotic surgicalsystem of claim 9, wherein the processor is configured to generatecontrol instructions for the first and second actuators.
 16. The roboticsurgical system of claim 9, wherein the processor is configured toidentify a midpoint between endpoints of the first and second arms and,when the midpoint is positioned outside a predetermined area, togenerate the control instructions such that at least one of the grosspositioning device and the robotic surgical device operates to move themidpoint back within the predetermined area.
 17. A robotic surgicalsystem for performing surgery on a patient, the system comprising: (a) agross positioning device comprising: (i) a base; (ii) a first arm linkoperably coupled to the base at a first rotational joint, wherein thefirst rotational joint comprises a first motor; (iii) a second arm linkoperably coupled to the first arm link at a second rotational joint,wherein the first rotational joint comprises a second motor; (iv) athird arm link operably coupled to the second arm link, wherein thethird arm link is rotatable about a third rotational joint, wherein thefirst rotational joint comprises a third motor; and (v) a couplingmechanism coupled to the third arm link such that the coupling mechanismis moveable along a length of the third arm link between an extendedposition and a retracted position; (b) a robotic surgical deviceremovably coupled to the coupling mechanism, the robotic surgical devicecomprising: (i) a device body; (ii) a first arm operably coupled to thedevice body, the first arm comprising a first actuator and a first endeffector; and (iii) a second arm operably coupled to the device body,the second arm comprising a second actuator and a second end effector;(c) a controller operably coupled to the gross positioning device andthe robotic surgical device, the controller comprising first and secondhand controllers; and (d) a processor operably coupled to thecontroller, the processor is configured to generate control instructionsfor the gross positioning device and the robotic surgical device suchthat the gross positioning device and the robotic surgical deviceoperate together to position the robotic surgical device and the firstand second arms within a body cavity of the patient.
 18. The roboticsurgical system of claim 17, wherein the processor is configured togenerate the control instructions for at least the first, second, andthird motors and the first and second actuators such that the grosspositioning device and the robotic surgical device operate togethersimultaneously to position the robotic surgical device and the first andsecond arms within the body cavity of the patient.
 19. The roboticsurgical system of claim 17, wherein the processor is configured togenerate the control instructions for the gross positioning device andthe robotic surgical device such that a first of the gross positioningdevice and the robotic surgical device operates to position the roboticsurgical device and the first and second arms within the body cavity ofthe patient while a second of the gross positioning device and therobotic surgical device is inoperable.
 20. The robotic surgical systemof claim 17, wherein the processor is configured to identify a midpointbetween the first and second end effectors and, when the midpoint ispositioned outside a predetermined area, to generate the controlinstructions such that at least one of the gross positioning device andthe robotic surgical device operates to move the midpoint back withinthe predetermined area.